Insurance Services

Family and Medical Leave Administration

We help our customers manage the administrative challenge of complying with the Family and Medical Leave Act (FMLA) of 1993. The FMLA requires private-sector employers with 50 or more employees to provide up to 12 work weeks of unpaid, job-protected leave, within any 12-month period, to eligible employees for certain family and medical reasons. Employees may take leave intermittently, thereby reducing their normal weekly work schedule. Our programs are available both as part of our Integrated Disability Management or as a separate service.

Help Manage Costs and Improve Employee Satisfaction with our FMLA Program

Our Family and Medical Leave program helps reduce administrative burdens, improve employees’ satisfaction, and helps reduce both the direct and indirect costs of employee FMLA absence.

  • We automate absence control policies, with the ability to administer different rules for employee groups (e.g., union, department, or location).
  • We track leave durations, including the 12-month period measured forward and “rolling” 12-month period measured backward.
  • We track improvements by automatic deduction and roll-off of incidents.
  • We administer and certify concurrent FMLA leaves with disability and workers’ compensation.

In addition, our dedicated adjusters educate employees, answer their questions or concerns, and send reminders when documents are due. We process all aspects of employee FMLA absence through our in-house staff and technology system, including:

  • intake
  • approval
  • adjudication
  • payment
  • return-to-work
  • record keeping
  • reporting

Why outsource FMLA to AmeriHealth Casualty?

  • Implementation — We will work with the employer to develop a program that meets your needs and goals as well as documents legislative compliance.
  • Claim Intake — Our system is designed with logic to ensure we are consistently following the appropriate path of questions for each individual claimant.
  • Call Center — A toll-free customer service line is available for employees and supervisors to call with inquiries concerning FMLA policies and specific leave activity.
  • Determining Eligibility — Our system reviews the claimants’ eligibility for all federal rules and will provide the Case Manager with the appropriate determination for each, ensuring the federal timelines are met.
  • Managing your Claims
    • Automated tasks based on your business workflow will ensure legal compliance while again maximizing the productivity of your operation.
    • Employer e-mails will be sent notifying them of the decisions of claims. Determinations will be scheduled in a timely manner and recertification notifications will eliminate lapses in coverage.
    • Notifications of an employee exceeding frequency and duration of approved intermittent leaves will allow a proactive approach to managing your claims.
    • Automated 75% and 100% exhaustion of benefit notifications will be sent so that both the employee and employer can make appropriate accommodations.

Want to know more about AmeriHealth Casualty? Call 1-800-297-2726.